9 April 2020
Recommendations to the National Cabinet around management of health risk for Australian crew on international flights
Air crew are essential to maintain the international air bridge between Australia and other nations. These air services are required to repatriate Australian citizens and to ensure the carriage of essential supplies to Australia.
In order to support this service, air crew have been exempt from quarantine. This allowed air crew to have time at home and maintain a semblance of normal life and has ensured that crew were happy and available to staff essential flights.
This approach was supported for several reasons. Firstly, air crew have additional training in infection control management and controls were in place to ensure social distancing. Secondly, air crew do not have the same risk of disease as Australians travelling in areas with community sustained transmission. Air crew travel to locations on Australian air craft and self-isolate whilst away and should return to Australia without having interacted with members of the at risk destination communities.
The recent cluster amongst flight crew raised awareness of the risk of COVID-19 in returning flight crew. It noted specific failures in controls. These have been addressed. In response to concerns around the risk of transmission to the Australian community, AHPPC undertook a review to ensure measures appropriately protect air crew, passengers and the Australian community.
AHPPC reviewed the issue and advises that management of health risk to crew, passengers and the Australian community must be based on a systematic risk assessment and application of strict mitigations using the hierarchy of controls. This will require the application of multiple controls providing ‘defence in depth.’
These measures include controls at every level noting that higher level controls are preferred. Measures include:
Engineering: If possible use an aircraft with personalised ventilation as this has been shown to reduce cross infection. Higher frequency air exchange and alteration in temperature may also be considered.
Movement: Movement of passengers and crew can facilitate transmission of disease and should be minimised. Meal and drink service must be minimal or prepackaged.
Seating: Risk of direct transmission is reduced by distance. Crew should be seated away from passengers and appropriate distance should be maintained between crew members where possible.
Contact: Contact between aircrew and passengers must be minimised. As noted catering should be simplified and pre-prepared meals may be a useful control.
Hygiene: There must be an enhanced cleaning regimen and additional hygiene measures.
Management in destination country: Air crew will undertake strict social distancing and self-isolation in nearby or airport hotel accommodation. They must self-isolate in their room and access meals through room service. Strict hand and respiratory hygiene must be maintained. The shortest possible stay to allow appropriate rest should be facilitated.
Management at home: With additional measures in place, on return home air crew will now be asked to self-isolate in their home between flights or for 14 days, whichever is shorter. If air crew share their home with vulnerable people, provision of alternate accommodation should be considered by airlines.
Other: Aircrew will review guidelines and ensure enhanced infection control measures as part of the flight practique. Additional training or inflight specialist support for infection control should be considered.
Personal protective equipment
Considering the rates of community transmission in some of the locations (specifically the US and UK) and the potential risk related to presymptomatic or asymptomatic transmission, it is now recommended that passengers wear masks on these flights. These should be used in accordance with manufacturer’s instructions. Masks can be removed for meals.
Aircrew should wear masks when within 1.5 metres of passengers. These should be used in accordance with manufacturer’s instructions. When cleaning, masks, gowns and gloves should be used.
Air crew are essential to maintain the international air bridge between Australia and other nations.
International flights have been considerably reduced. Flights for essential freight continue. In addition to the requirement for essential freight, the Australia government has agreed to support the repatriation of stranded Australians. This will be provided through scheduled and unscheduled flights by Australia’s two international airlines, Qantas and Virgin Australia. Qantas will fly to London, Los Angeles, Hong Kong and Auckland commencing on 9 April 2020.Virgin Australia will operate to Los Angeles and Hong Kong commencing on 8 April 2020.
Maintaining these services does carry some risk but this can be managed via a comprehensive risk assessment and the application of layered controls to manage the health risk to the crew, any passengers and also protects the Australian community.
The important additional controls include:
- Self-isolation of crew members following international flights.
- Increased administrative controls including a range of additional measures to reduce transmission of infection.
- Enhanced use of personal protective equipment for air crew and passengers.
Read previous statements from the AHPPC